RESUMO
INTRODUCTION: Given the high rate of complete nodal response, the role of axillary lymph node dissection on staging the axilla has been questioned. This survey, addressed to breast cancer surgeons in Spain, has the objective of assessing current clinical trends on axillary staging of cN + patients treated with NAC. METHODS: An online survey was conducted among breast surgeons from the Spanish Society of Surgery (AEC), Spanish Surgical Oncology Society (SEOQ), Spanish Breast Cancer Surgeons Society (AECIMA) and Spanish Gynecology and Obstetrics Society (SEGO). It was structured in 5 sections: general information and clinical practice, knowledge of clinical trials, diagnosis work-up and nodal marking, axillary staging, and axillary treatment. RESULTS: 150 breast cancer surgeons completed the full survey (96.7%). 81.8% of respondents performed SLNB or targeted axillary dissection in cN1 patients treated with NAC. Radiological axillary response was the preferred parameter guiding the surgical strategy. The excision of the clipped node (92.0%), use of dual tracer (73.2%), and axillary US (65.9%) after treatment were the most important variables considered by respondents, to increase the accuracy of SLNB in cN + patients. CONCLUSION: This survey confirms a trend toward a less invasive approach for axillary staging in cN + patients treated with NAC among breast cancer surgeons in Spain. While there is widespread agreement in less invasive approaches to axillary staging, there is, however, a lack of consensus around treatment strategy. Further, it shows a wide heterogeneity in their clinical practice. This study highlights the need for clear evidence concerning less invasive staging procedures and their oncological safety, to ensure consistent recommendations in surgical practice.
Assuntos
Neoplasias da Mama , Cirurgiões , Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela/métodos , Terapia Neoadjuvante/métodos , Espanha , Axila , Estadiamento de Neoplasias , Excisão de Linfonodo/métodos , Inquéritos e Questionários , Linfonodos/cirurgia , Linfonodos/patologiaRESUMO
In this work, the inner filter effect (IFE) of caffeine (CF) over the fluorescence signal of glibenclamide (GLB) was used for the determination of CF in beverage samples. The system worked in a turn-off mode since the absorption spectrum of CF overlaps the excitation band of GLB resulting in a decline in its fluorescence signal (λexc = 234 nm, λem = 350 nm). No changes in the fluorescence lifetime of GLB (0.29 ns) were observed in the presence of CF up to 127.6 mg L-1 concentration. The parameters that affect the fluorescence intensity were investigated, such as fluorophore concentration (16 mg L-1), pH (3.2) and temperature (25 °C). Under optimized conditions, the IFE-based approach can determine CF in a range between 1.00 and 100.0 mg L-1, with a detection limit (LOD) of 0.10 mg L-1. The relative standard deviation (% RSD) values for the intra-day and inter-day precision were 0.75 and 1.24, respectively. The new method was successfully tested in the determination of the target analyte in beverage samples without previous treatment. The results were compared with those obtained by a reference method, leading to the conclusion that there were no significant differences at the studied confidence level (α = 0.05).
Assuntos
Cafeína/análise , Café/química , Bebidas Energéticas/análise , Espectrometria de Fluorescência/métodos , Chá/química , Corantes Fluorescentes/química , Glibureto/química , Limite de DetecçãoRESUMO
RESUMEN Introducción: La obesidad ha estado relacionada con la presencia de adaptaciones estructurales y funcionales que provocan limitaciones en el control del movimiento. Objetivo: Determinar el efecto del exceso de peso sobre las variables espacio-temporales de la locomoción en varones jóvenes y activos. Métodos: Estudio de corte transversal de muestreo no probabilístico con 55 sujetos con normopeso (IMC ≤25) y 22 sujetos con sobrepeso (IMC >25). Se analizó el IMC, % de masa grasa, y el % de masa magra de ambos grupos con un bioimpedanciómetro multifrecuencia (Inbody 230). También se analizaron las variables cinemáticas de la locomoción utilizando una plataforma de presiones GaitRite. Resultados: El grupo con sobrepeso mostró una disminución significativa de la fase de oscilación y fase de apoyo monopodal (p <0,001) junto con un aumento de la fase de apoyo y fase de apoyo bipodal (p <0,001) comparado con el grupo normopeso. Conclusión: La reducción de la fase de oscilación y el incremento de la fase de apoyo y fase de apoyo bipodal que manifestaron el grupo con sobrepeso puede ser consecuencia del aumento de la inestabilidad que se produce durante la marcha debido al sobrepeso.
RESUMO Introdução: A obesidade tem sido relacionada com a presença de adaptações estruturais e funcionais que podem limitar o controle dos movimentos. Objetivo: Determinar o efeito do excesso de peso sobre as variáveis espaço-temporais da locomoção em homens jovens e ativos. Métodos: Estudo transversal de amostragem não probabilística, com 55 indivíduos com peso normal (IMC ≤25) e 22 indivíduos com sobrepeso (IMC >25). Analisaram-se IMC e porcentagem de massa gorda e massa magra em ambos os grupos, com um bioimpedanciômetro multifrequência (Inbody 230). Foram analisadas também as variáveis cinemáticas de locomoção, usando-se um sistema de plataforma de pressão (GaitRite). Resultados: O grupo sobrepeso apresentou diminuição significativa na fase de balanço e fase de apoio monopodal (p <0,001), com aumento da fase de apoio e da fase de apoio bipodal (p <0,001) com relação ao grupo peso normal. Conclusão: A redução da fase de balanço e o aumento da fase de apoio e da fase de apoio bipodal manifestado pelo grupo sobrepeso pode ser resultado do aumento da instabilidade que ocorre durante a marcha, devido ao sobrepeso.
ABSTRACT Introduction: Obesity has been associated with the presence of structural and functional adaptations that may limit movement control. Objective: To determine the effect of overweight on spatio-temporal variables of locomotion in young and active men. Methods: A cross-sectional study of non-probability sampling, with 55 subjects with normal weight (BMI ≤25) and 22 overweight subjects (BMI >25). Body mass index and percentage of fat mass and lean mass were analyzed in both groups, with a multi-frequency bioimpedanciometer (Inbody 230). The kinematic variables of locomotion were also analyzed with a pressure platform system (GaitRite). Results: The overweight group showed a significant decrease in the swing phase and monopodal stance phase (p <0.001) with an increase in the stance phase and double stance phase (p<0.001) in relation to the normal weight group. Conclusion: The reduction of the swing phase and the increase of the stance phase and double stance phase presented by the overweight group may be a result of increased instability that occurs during gait due to overweight.